Virtual Surgical Planning for Reconstruction of Mandibular Osteoradionecrosis: A Comparative Study on Its Safety and Outcomes.

BACKGROUND

The role of virtual surgical planning (VSP) in mandibular osteoradionecrosis (ORN) surgery remains uncertain due to the challenges posed by irradiated tissues

METHODS

A consecutive series of patients with mandibular ORN undergoing resection and reconstruction with vascularized hard-tissue free flaps between 1996 and 2004 was included. VSP was analyzed as a predictor variable for ORN recurrence, fixation plate removal, and malocclusion.

RESULTS

Among 120 patients with mandibular ORN, 49 patients underwent VSP-guided resection and reconstruction. Multivariable Cox proportional hazards regression demonstrated a hazard ratio of 0.544 (95% CI: 0.098-3.010, p = 0.485) for ORN recurrence and 0.349 (95% CI: 0.145-0.841, p = 0.019) for plate removal. VSP was significantly associated with reduced malocclusion in 2 out of 30 dentate patients, compared to 10 out of 29 dentate patients in the non-VSP group (p = 0.010).

CONCLUSIONS

VSP appears to be safe for ORN surgery with reduced rates of postoperative complications of plate removal and malocclusion.